Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4550
Peer-review started: September 21, 2021
First decision: October 22, 2021
Revised: November 3, 2021
Accepted: March 25, 2021
Article in press: March 25, 2021
Published online: May 16, 2022
Treating periodontally hopeless teeth with advanced bone resorption and severe tooth mobility is a great challenge for both orthodontists and periodontists. Biofilm-induced periodontal inflammation and occlusal trauma-related inflammation may synergistically aggravate tooth mobility. This case report illustrates that even periodontally hopeless teeth can be saved and have long-term stability with comprehensive periodontal treatment to control periodontal inflammation and promote periodontal bone regeneration and intricate orthodontic mechanical control to correct cross bite and occlusal trauma.
A 27-year-old female patient whose chief complaint was severe tooth mobility and discomfort of the maxillary incisor was diagnosed with severe aggressive periodontitis by clinical and radiographic examinations. To reduce tooth mobility and establish stable occlusion, we combined orthodontic treatment with periodontal therapy to preserve the tooth. Orthodontic treatment was performed after basic periodontal therapy and periodontal surgery. The loosened upper right central incisor was successfully retained, and the periodontal tissue remained stable during follow-up.
Teeth with severe mobility and bone loss can be saved through interdisciplinary treatment when periodontal inflammation is strictly controlled.
Core Tip: Traditionally severe tooth mobility may affect the prognosis after orthodontic tooth movement, since orthodontic treatment has been reported to increase tooth mobility. However, whether orthodontic tooth movement can be conducted in “periodontally hopeless teeth” with Class III mobility has never been reported. In this case report, we described periodontal-orthodontic interdisciplinary treatment of a case with a “periodontally hopeless” upper central incisor with Class III mobility.